Thermo-therapeutical method and apparatus



0t.27,1'936. c. R. ELL1OTT- 2,058,780

THERMO THERAPEUTICAL METHOD AND APPARATUS Filed March 28, 1931 2 Sheets-Sheet 1 l BY @Mpwg ma M ATTORNEYS Oct. 27, 1936.

Fileduaroh ze, 1931 c.- R. ELLloTT THERMO THERAPEUTICAL METHOD AND APPARATUS 2 Sheets-Sheet 2 Heafer Ammerer ElEI/E//T INVENTOR CHARLES WBERT ELL/077' v BY ATTORNEYS Patented Oct. l27, 1936 UNITED STATES PATENT OFFICE THERMo-THERAPEUTIGAL METHOD I AND APPARATUS 'l Claims.

This invention relates to thermo-therapy and has forits object the provision of an improved method and apparatus for carrying out thermotherapeutical treatments. More particularly, the invention relates to thermo-therapeutical treatment of the body cavities, such as thevagina, rectal applications for treatment of the prostate gland and the like.

Practically all of the pathogenic bacteria which cause disorders in the human system thrive best at body temperature. Variations of temperature above and below the same ordinarily tend to interfere with the vitality and growth of such bacteria. For certain hardy types of harmful bacteria quite elevated temperatures are required to destroy them or to render them suciently innocuous. Heretofore, however, it has not been Bil possible to use the desirable higher temperatures due to the resulting necrosis and burning oi the tissue.

I have found that if thermal applications are made in the manner hereinafter set forth temperatures materially higher than those heretofore safely utilizable can be applied and remarkable therapeutic results eected.

i In the more specific aspects of the procedure, as applied to the vagina for illustration, a distensible bagl of suitably conductive material is inserted into the Vaginal tract, water or other iiuid at a moderate temperature is introduced into and circulated through the bag under suicient pressure to cause such distension thereof as will bring it into intimate contact with the walls of the vagina, and while maintaining the contact, the temperature or" the circulating fluid is gradually elevated over a suitable period of time until the desirably elevated temperature is attained.

in the accompanying drawings l have shown an illustrative form of apparatus for carrying out the method oi my invention.

in the drawings:

l is a 'iront view o the apparatus;

2 is a plan view with the top of the apparatus removed;

3 is a vertical section taken along the line or Fig. 2;

Fig. i is an illustration of a type oi bag suitable ior vaginal application; and

Fig. 5 is a wiring diagram.

Referring to the drawings, reference numeral designates the outer casing oi the apparatus comprising a panel board t (Fig. l), which casencloses tank (Figs. 2 and 3l for the water or other duid treating medium. asupply (Cl. 12S-401) pipe 8 provided with a screw cover 9 extends from the top of the apparatus to the tank to permit the periodic lling thereof as required.

A discharge pump Il and an intake pump l2 of the turbine or other suitable variety are provided within the tank l to cause circulation of the iiuid through the circulatory system, to be hereinafter described, and it is desirable that both pumps be disposed a suitable distance .below the top of the tank to assure their immersion in the fluid. Reference numerals i3 and I4, respectively, designate the inlet and outlet of pump il, and I5 and I6 the inlet and outlet, respectively, of pump l2. The discharge pump Il feeds the dischargebranch of the system which coinprises a pipe Il leading from the pump and connesting with a conduit I8 provided in one end of a rectangular block i9, which conduit leadsi to a discharge nipple il. ln the return branch of the system a return nipple 22 leads to a conduit 23 provided at the opposite end of the block lil and this conduit is connected by means of a pipe 2li with the intake pump l2'. The pumps are driven by a suitable electric motor 25 of either the variable or constant speed type as desired and preferably provided with a fan 26 to keep the motor cool.

A heating element 2l of suitable heating capacity, and preferably or" the well known wirewound resistor type, is disposed within a waterprooi compartment 2i! in the tank ll. To permit regulation of the temperature of such heating element a rheostat i@ of any suitable and well known type is included in the heating element circuit. A sliding contact blade 3l operated by a knob 32 is mounted on the panel board t and by selective contact oi said blade with the metal' studs of the rheostat -the desired resistance may be thrown into the circuit, all in the well known manner. The temperature of 'the heated fluid being discharged from the tank l is indicated by a thermometer lf3 ci any suitable type, the bulb oi which projects into the iluid passing through the conduit which thermometer is externally visible through a window provided in the panel board Pressure in the system is indicated by a pressure gauge 3@ oi any suitable type which may be mounted in the conduit i@ and so disposed that the dial Sil registers with an aperture provided thereior in the panel board The prevailing level of the liquid in the tank 'l may be ascertained by the use of a liquid level indicator di; connected with the tank l' at the bottom thereoi' and operated simply by the hydrostatic balance. The communicating piping 39 between the tank and the liquid level glass 4I is preferably so disposed and extended that the glass is in close proximity to the panel board 5 so that it may be observed through the window.

42 provided in the board.

In Fig. 4, I have shown one form of bag 45 which is very satisfactorily applicable in treatments of the vagina. This bag consists of a casing 44 of rubber or other suitable distensible and waterproof material, which casing is formed with a collapsible wing or lateral extension 45, a similar collapsible opposite wing or lateral extension 46 and a neck 41. A stopper 48 is tted tightly into the neck 41 and carries inlet and outlet pipes 49 constructed of hard rubber or other suitable material and provided with nipples 5i, over which are fitted the rubber tubes 52 and 53 which connect respectively with the discharge and return nipples 2l and 22 of the pumping apparatus.

In order to regulate the distension of the bag produced by the pressure of the uid circulating through the system and also to regulate the flow of the circulating fluid either as anadjunct to or in the absenceof variable speed in the motor 25. a valve 54 is provided in the conduit i8 of the discharge branch of the system, and a similar valve 55 is disposed in the conduit 23 of the return branch of the system. For this purpose any suitable type of valve may be used and in the illustration shown each valve consists of a rotatable, frusto-conical plug 56 provided with a transverse duct 51 for the passage of the fluid through the plug. 'I'he valve is snugly fitted in a frustoconical seat formed in the block I8 and a spring 55 is interposed between a washer 59 and` a flanged head 5| on the plug to aid in maintaining the same in position so that the duct 51 will at all times be disposed within the conduit. The opposite end of the valve connects with a knurl or valve control 52 mounted on the panel board 5 externally of the casing 5.

Fig. 5 is a wiring diagram for the apparatus, which is self-explanatory.

An illustrative manner of carrying out the therapeutic method of my invention utilizing the apparatus described is as follows:

The tank 1 is iilled with water or other suitable fluid and by means of the electric heater 21 the temperature thereof is elevated to a degree suit# able for the initial application of the treatment medium to the vaginal cavity, for example, to i90-105 F. With the tubes 52 and 53 connected with the bag 43 and respectively with the discharge and return nipples 2| and 22 of the apparatus, the bag while in collapsed condition is inserted into the vagina: The motor is then strated to operate the pumps and cause a circulation of water through the system with the valves 54 and 55 in a fully open position.

The flow of water into and through the bag ,43 will cause some slight initial distension of the same and when the circulation is functioning properly the valve 55 is then regulated to gradually restrict the now of water through the return branch of the system until sumcient back-pressure has been built up to produce the desired distension of the bag within the vagina. No matter what the position of the wings 4545 may be when the collapsed bag is inserted into the canal, upon distension they will assume their proper position therewithln.

The extent to which the internal pressure in the bagahouldbebuilt up.ahnuld be such that the resulting distension of the bag will smooth out the folds of the vaginal canal to a suitable extent and bring the bag in quite intimate contact with ".he membrane of the vagina.` In utilizing the distension for this purpose, however, care should be taken that the pressure upon protruding portions of the tissue should not be so excessive that the blood will be pressed out of the tissue, with the possibility of a local necrosis upon the subsequent elevation of the temperature. 'I'his undesirable local pressure may be avoided by utilizing a bag which is constructed of suitably elastic material, for example very thin rubber, which will tend to expand into the depressions and conform with, rather than tend to flatten out, protuberances which offer undue resistance.

In lieu of the pressure developing and circulation system noted, in which the pumps Il and l2 are of the same capacity and the back pressure is built up by regulation of the valve 55, a discharge pump Il lmay be used which has a greater capacity than the intake pump I2, with the resultant provision of a normal pressure differential between the discharge and intake lines. If such an arrangement is utilized, at the commencement of the operation the valve 54 should be closed to a suitable extent to prevent undue inflation of the bag 43 and thereafter opened as necessary to produce the distension desired, with appropriate regulation of the valve 55, if necessary.

The pressure registered by the pressure gauge 35 and the loss of water from the tank 1 indicated by the liquid level glass 4| will afford indicia of the distention produced and will aid in the instant and subsequent treatment of a patient.

When the desired distension has been obtained the Water is then permitted to circulate `through the bag for a short period of time at the moderate initial temperature, for example, 105 F., to permit the vaginal region to become accustomed to that degree of heat. Thereafter the temperature is gradually elevated, an increase of threequarters'of a degree Fahrenheit per minute, providing in general a satisfactorily graduated increase. This temperature increase is obtained by suitable regulation of the temperature of the heating element 21 through the medium of the rheostat orotherwise with observation of the thermometer 34. If desired, a suitable automatic thermostatic control may be utilized.

By applying the dry heat in the manner noted in close contact with the membrane and with gradual elevation of the temperature, it is possible to attain without ill effect, temperatures considerably higher than heretofore could be safely utilized and I have found that highly desirable therapeutic results are secured at the elevated temperatures obtainable. Temperatures as high as L10-145 F. have been attained in a great many instances without detrimental eiector undue discomfort to the patient and with striking therapeutic eifects. While such highly elevated temperatures are not always necessary, I have found that in general a temperature of not less than approximately 125 F. should be utilized.

One explanation which may be advanced with respect to the effect of the treatment is as follows: As the temperature of the region in contact with the bag is graduallyelevated by the increasing temperature of the liquid circulatingv through the bag, the blood vessels in the vascular region gradually dilate. This dilation of the blood vessels is appreciabiy greater at the higher temperatures than at the lower. With such dilation a greater quantity of blood will pass through the enlarged vessels and will serve to carry away the excess heat which otherwise would cause considerable discomfort if mild, and necrosis or burning if unduly elevated. In addition, this active hyperemia quite probably contributes to the normalization of the tissue affected, for example vby relieving congestion in the tissue, by destruction or attenuation (or what might be called rendered comatose or non-Virulent) of the bacteria, apart from the effect of the heat, or by some other action.

With respect to the heat and temperature effect, the heat from the hightemperature bag will tend to destroy or attenuate the bacteria which lie in contact therewith and within the elfective penetration range in the tissue.

In addition to the heat effects, a distinct physiological reaction is produced in the blood stream due to the enlargement of the blood vessels, viz., the production of leukocytosis to such an extent that the number of leukocytes or enemies of bacteria in the blood is very greatly increased, for example, from 10 to 50 per cent in forty-live minutes. With the increase in the number of leukocytes the destruction and attenuation of the bacteria will be greatly enhanced and furthermore as regards destruction, the same will be accomplished with relative ease in the case of the bacteria already weakened by attenuation as a result of the heat, etc.

Whatever the exact mechanics of the operation and the relative influences of the various elements noted may be, however, the fact remains that by proceeding in accordance with the method noted and the attainment of elevated temperatures, the beneficial effects which result are very marked.

The application of the method and apparatus of my invention just described is intended merely to be illustrative and various changes yin .and-

other applications of the same may be made as will be apparent to one skilled in the art. Their application is not, for example, limited to treatment of the vagina, but may also be applied to treatment of the rectum, the nasal and aural cavities, etc. In the treatment of such cavities, of course, the bags utilized should be of such construction as to conform to those cavities. Likewise, the method and apparatus may be utilized to apply a gradually decreasing degree of temperature where the beneficial effect of low temperatures is sought.

I claim:

1. The method of applying thermo-therapeutical treatments which comprises, disposing a heat-transmitting inflatable container Within a body cavity, inilating said container to bring it into intimate contact with the walls of said cavity, circulating a iluid through said'` container while maintaining said inflation, and progressively elevating the temperature-of said lluid at a rate not substantially exceeding approximately three-quarters of a degree F. per minute.

2. The method of applying thermo-therapeutical treatments which comprises, disposing a heat-transmitting inflatable container within a body cavity, inilating said container to bring it into intimate contact with the walls of said cavity, circulating a fluid through said container while maintaining said inflation, progressively elevating the temperature of said fluid at such a degree of gradation that necrosis of the tissue is avoided, and continuing said progressive elevation until a temperature of not less than approximately 125 F. is obtained.

3. The method of applying thermo-therapeutical treatments which comprises, disposing a. heat-transmitting inflatable container within a body cavity, inlating said container to bring it into intimate contact with the walls of said cavity, circulating a fluid through said container while maintaining said inflation, progressively elevating the temperature of said fluid at a rate not substantially exceeding approximately threequarters of a degree F. per minute, and continuing said progressive elevation until a temperature of not less than approximately 125 F. is obtained.

4. The method of applying thermo-therapeutical treatments which comprises, disposing a. heat-transmitting inflatable container within a body cavity, inilating said container to bring it into intimate contact with the walls of said cavity, circulating iluid through said container under suitable pressure to maintain said inflated contact, progressively elevating the temperature of said fluid at a rate not substantially exceeding approximately three-quarters of a degree F. per minute, and continuing said progressive elevation until a temperature of not less than approximately 125 F. is obtained.

5. The method of applying thermo-therapeutical treatments which comprises, circulating uid in non-contacting heat-transmitting relationship to the walls of a body cavity, said fluid having an initial temperature of approximately to 105 F., progressively elevating the temperatureof said fluid at a rate not substantially exceeding approximately three-quarters of a degree F. per minute, and continuing said progressive elevation until a temperature of not less than approximately F. is obtained.

6. The thermo-therapeutical apparatus which comprises, an inflatable bag adapted to be disposed within a body cavity, pump means for circulating fluid through said bag, heating means for gradually elevating the temperature of the fluid, and means for providing a pressure differential between the stream of liquid supplied to said bag and the stream of liquiddischarged from said bag whereby said bag will be distended. '7. In a thermo-therapeutical apparatus of the class described, a casing, a fluid container therein, a heating element in the container, means for varying the heat produced by said heating elernent, a pump for discharging fluid from said container, a pump for drawing uid into said container, a source of power having a common driving connection with both said pumps, a header having a bore extending partially thereinto from one end, said bore being connected to the discharge from said container and a bore extending partially thereinto from the other end, said second bore being connected to the intake pump, said respective bores having respective connections for discharging the fluid to and Withdrawing it from an external apparatus, and means in the discharge end of the header for varying the rate of flow of the discharged fluid and means in the other end for varying the rate of flow of the inclrawn fluid.

CHARLES ROBERT ELLIGTI. 

